Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap.
OBJECTIVE
The purpose of this study was to evaluate tongue function and donor site morbidity in patients with oral cancer surgically treated and reconstructed with radial or anterolateral thigh free flaps.


METHODS
Twenty patients underwent primary reconstruction after hemiglossectomy between January 2002 and June 2004. Ten patients were reconstructed using a free forearm flap and the remaining with an anterolateral thigh flap. Eight patients on each group underwent postoperative radiotherapy (average, 60 Gy). All of them were followed postoperatively to determine after 6 months their functional outcome as it related to speech, deglutition, tongue mobility, and donor site morbidity. The intelligibility, deglutition, and tongue mobility were each scored on a scale ranging from 1 to 7 by an independent investigator. Data were analyzed by the 2-tail Mann-Whitney U test.


RESULTS
No differences in mean speech intelligibility, tongue mobility, or deglutition mean scores were seen between radial forearm flap and anterolateral thigh flap (P > .05). In all anterolateral thigh flap-treated cases, the donor site was closed directly and no complications were seen. However, in all forearm flaps donor site closure was carried out with skin grafts and dorsal forearm splinting was applied for 1 week postoperatively. In 4 cases a partial skin graft failure was observed and donor sites healed for second intention.


CONCLUSIONS
Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, and low donor site morbidity, could be the ideal flap for hemiglossectomy defect reconstruction.
de Vicente
Juan Carlos
JC
Servicio de Cirugía Maxilofacial, Facultad de Medicina y Odontología, Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain. jvicente@uniovi.es
de Villalaín
Lucas
L
Torre
Aintzane
A
Peña
Ignacio
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation*; D003679:Deglutition; D005260:Female; D005542:Forearm / Q000473:pathology / Q000601:surgery; D005927:Glossectomy / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D019651:Plastic Surgery Procedures; D013065:Speech Intelligibility; D013524:Surgical Flaps / Q000098:blood supply; D013848:Thigh / Q000473:pathology / Q000601:surgery; D020858:Tissue and Organ Harvesting; D014059:Tongue / Q000503:physiopathology / Q000601:surgery*; D014062:Tongue Neoplasms / Q000532:radiotherapy / Q000534:rehabilitation / Q000601:surgery*